TITLE: Shilla and MAGEC Systems for Growing Children with Scoliosis: A Review of the Clinical Benefits and Cost-Effectiveness
|
|
- Kevin Harris
- 5 years ago
- Views:
Transcription
1 TITLE: Shilla and MAGEC Systems for Growing Children with Scoliosis: A Review of the Clinical Benefits and Cost-Effectiveness DATE: 17 January 2013 CONTEXT AND POLICY ISSUES Early-onset scoliosis (EOS) is a structural, lateral curvature of the spine in children younger than five years of age. In Europe, it affects 1-2 children out of every 10,000 people a rate that is four times higher than in the USA. 1 With EOS there is progressive deformity of the spine and abnormal pulmonary function. 1 Management of EOS depends on the age of the patient, type and severity of the curve, and progression of the condition. Management of EOS included nonsurgical treatment such as casting or bracing of the spine, and surgical procedures such as spinal fusion and spinal implants. 1,2 Currently used spinal implants comprised of single rod, dual rod, and vertical expandable prosthetic titanium ribs (VEPTR). 2 The use of current growing rods, requiring general anesthesia and invasiveness of repeated lenghthening surgeries, has resulted in suboptimal results, including implant pullout, rod breakage, infections and alignment problems that require multiple revision surgeries. 3 Recently, novel techniques such the Shilla procedure (Medtronic Spine Inc., Memphis, TN) and magnetic growing rods [Magnetic Expansion Control System (MAGEC Ellipse Technologies, Inc., Irvine, CA) and the Phenix rod (Phenix Rod, France)] have been developed in the hope to overcome the drawbacks of current techniques. 4 The Shilla system in which the rods are fixed to the screws at the apex but can slide at the proximal and distal ends, allows for curve control while permitting spine growth without the need for surgical lenghthening. 4,5 The MAGEC system, which could be comprised of a single rod or dual rod system that could be elongated with an external magnet, was also designed to avoid lenghthening surgeries. 4,5 Clinical effectiveness of the techniques on patients with scoliosis are usually based on radiographic evaluation criteria such as Cobb angle changes and spinal height gain. This report will provide a review of the clinical and cost effectiveness of the Shilla and the MAGEC systems for growing children with scoliosis. Disclaimer: The Rapid Response Service is an information service for those involved in planning and providing health care in Canada. Rapid responses are based on a limited literature search and are not comprehensive, systematic reviews. The intent is to provide a list of sources and a summary of the best evidence on the topic that CADTH could identify using all reasonable efforts within the time allowed. Rapid responses should be considered along with other types of information and health care considerations. The information included in this response is not intended to replace professional medical advice, nor should it be construed as a recommendation for or against the use of a particular health technology. Readers are also cautioned that a lack of good quality evidence does not necessarily mean a lack of effectiveness particularly in the case of new and emerging health technologies, for which little information can be found, but which may in future prove to be effective. While CADTH has taken care in the preparation of the report to ensure that its contents are accurate, complete and up to date, CADTH does not make any guarantee to that effect. CADTH is not liable for any loss or damages resulting from use of the information in the report. Copyright: This report contains CADTH copyright material. It may be copied and used for non-commercial purposes, provided that attribution is given to CADTH. Links: This report may contain links to other information available on the websites of third parties on the Internet. CADTH does not have control over the content of such sites. Use of third party sites is governed by the owners own terms and conditions.
2 RESEARCH QUESTIONS 1. What are the clinical benefits and harms associated with Shilla and MAGEC in growing children with scoliosis? 2. What is the cost-effectiveness of Shilla or MAGEC compared with dual growing rods in growing children with scoliosis? KEY FINDINGS There were no studies comparing the Shilla system or the MAGEC rods to current dual growing rods. Data from two studies with methodological limitations showed that the MAGEC rods can provide adequate curve correction and spine distraction, with no major complications. MAGEC dual rods seem to have better clinical benefits than MAGEC single rod systems. The instrumental cost of the MAGEC system is higher than the current growing rods. METHODS Literature Search Strategy A limited literature search was conducted on key resources including PubMed, The Cochrane Library (2012, Issue 12), University of York Centre for Reviews and Dissemination (CRD) databases, Canadian and major international health technology agencies, as well as a focused Internet search. Methodological filters were applied to limit retrieval to health technology assessments, systematic reviews, meta-analyses, randomized controlled trials, non-randomized studies, and economic studies. The search was also limited to English language documents published between January 1, 2003 and December 10, Selection Criteria and Methods One reviewer screened the titles and abstracts of the retrieved publications and examined the full-text publications for the final article selection. Selection criteria are outlined in Table 1. Table 1: Selection Criteria Population Pediatric population (<10 years) with scoliosis Intervention Shilla procedure MAGEC rods Comparator Dual growing rods Outcomes Clinical benefit/harms Cost-effectiveness (economic risks associated with devices and cost of treatment) Study design Health technology assessments, systematic reviews, meta-analyses, guidelines. If no systematic reviews were identified, randomized controlled trials (RCTs), non-rcts and case studies were selected for inclusion. Shilla and MAGEC Systems for Growing Children with Scoliosis 2
3 Exclusion Criteria Articles were excluded if they did not meet the selection criteria in Table 1, if they were published prior to January 2003, if they were duplicate publications of the same study, or if they were referenced in a selected systematic review. Critical Appraisal of Individual Studies The quality of the included prospective observational study was assessed using Downs and Black checklist. 6 Numerical scores were not calculated. Instead, the strengths and limitations of individual studies are summarized and presented. A formal quality assessment of case reports was not conducted since these study designs are considered to be inferior quality SUMMARY OF EVIDENCE Quantity of Available Evidence The literature search yielded 514 citations. Four additional studies were identified by searching the grey literature. After screening of abstracts, 11 potentially relevant studies were selected for full-text review. Two studies were included in the review. The PRISMA flowchart in Appendix 1 details the process of the study selection. Summary of Study Characteristics A detailed summary of the included studies is provided in Appendix 2. Study design The report included one prospective non-randomized study 7 and one case series. 8 Both studies were published in Length of follow-up was 10 months in the prospective non-randomized study and 24 months in the case series. Population The prospective study 7 included 14 patients (mean age 8 years plus 10 months) with EOS (five patients with single rod and 9 with dual rods). The case series 8 included two patients with EOS (age 5 years plus 8 months, and 12 years plus 1 month). In the case series, patient 1 had single MAGEC rod, and patient 2 had dual MAGEC rods. Interventions and comparators In both studies, all patients received either MAGEC system single or dual rods. 7,8 Neither of the included studies included other rod types as comparators. Outcomes The main outcome measures of the included studies were spinal curvature correction and spinal height gain. 7,8 The case series reported on instrument costs. Shilla and MAGEC Systems for Growing Children with Scoliosis 3
4 Summary of Critical Appraisal The included trials comprised one prospective non-randomized study, 7 and one case-series. 8 The prospective study included a small sample size (n = 14), was confounded by selection bias, and did not have a comparator group. The case series had two patients, did not have a comparator group and by design is considered to be of low scientific rigour. Details of the strengths and limitations of the prospective study are summarized in Appendix 3. A formal assessment of the case series was not performed. Summary of Findings Main findings of included studies are summarized in detail in Appendix What are the clinical benefits and harms associated with Shilla and MAGEC in growing children with scoliosis? There was no study found that compared the clinical effectiveness and harms of the Shilla system or MAGEC rods to current dual growing rods. The literature search found two noncomparative studies, one observational study 7 and one case series, 8 that reported the clinical effectiveness of the MAGEC rods on children with early-onset scoliosis. This limited evidence showed that the MAGEC rods provide adequate curve correction and spine distraction, with no major complications. The observational study was a multi-center non-randomized study that included 14 patients (mean age of 8 years plus 10 months) with early-onset scoliosis, using single or dual MAGEC rods, for a mean follow-up of 10 months. 7 Clinical effectiveness of the MAGEC rods was evaluated by measurement of the Cobb angle change and spinal length gain. Data showed that the magnetic controlled growing rod provided curve correction, and spinal distraction, and the changes were smilar to expected changes with standard growing rods. There was no major intra-operative and post-operative complications. Compared to MAGEC single rod system, MAGEC dual rod system provided better monthly growth of the T1 S1 segment, and the difference was statistically significant. The case series included 2 patients (aged 5 years and 8 months and 12 years and 1 month) with early onset scoliosis, using the MAGEC rods, for a follow-up time of 24 months. 8 Clinical effectiveness of the MAGEC rods was evaluated by measurement of the Cobb angle change and spinal length gain. Data showed that the magnetic controlled growing rod provided satisfying curve correction and spinal distraction in both patients. Patient 2 who had dual MAGEC rods had better instrumental segment length gain than patient 1 who had single MAGEC rods system (ststistical significance not reported) There was no study found on the clinical effectiveness and harms of the Shilla system. 2. What is the cost-effectiveness of Shilla or MAGEC compared with dual growing rods in growing children with scoliosis? There was no study found that compared the cost-effectiveness of Shilla or MAGEC with dual growing rods in growing children with scoliosis. The case series study reported MAGEC Shilla and MAGEC Systems for Growing Children with Scoliosis 4
5 instrumentation costs of HK$50,000 or US$6,451 and traditional growing rod costs of HK$25,000 or US$3, Limitations The available evidence on the clinical effectiveness of the Shiila and MAGEC systems is very limited in quantity and very weak in rigour. Non-randomized studies may be prone to selection bias, and the included study may have lacked adequate statistical power. Case studies are considered to be of inferior quality as they lack comparator or control groups and report on isolated events. There were no clinical or economic studies identified comparing the Shilla and MAGEC systems to current dual growing rod system. CONCLUSIONS AND IMPLICATIONS FOR DECISION OR POLICY MAKING One prospective observational study and one case series (two cases) found that the MAGEC rods can provide adequate curve correction and spine distraction, with no major complications. However, these findings should be interpreted with caution due to methodological concerns. The changes are comparable with expected changes using standard growing rods. Dual MAGEC rods may give better clinical benefits than single MAGEC rod. The MAGEC instrumentation costs were higher than current dual growing rods, but the difference may be offset by less frequent operations by the former. Randomized controlled trials with larger population size, and cost-effectiveness studies are needed to confirm the findings. PREPARED BY: Canadian Agency for Drugs and Technologies in Health Tel: Shilla and MAGEC Systems for Growing Children with Scoliosis 5
6 REFERENCES 1. Debnath UK. Current concepts in the management of early-onset idiopathic scoliosis. Pediatr Health. 2010;4(3): Lenke LG, Dobbs MB. Management of juvenile idiopathic scoliosis. J Bone Joint Surg Am Feb;89 Suppl 1: Wick JM, Konze J. A magnetic approach to treating progressive early-onset scoliosis. AORN J Aug;96(2): Tis JE, Karlin LI, Akbarnia BA, Blakemore LC, Thompson GH, McCarthy RE, et al. Early onset scoliosis: modern treatment and results. J Pediatr Orthop Oct;32(7): Gomez JA, Lee JK, Kim PD, Roye DP, Vitale MG. "Growth friendly" spine surgery: management options for the young child with scoliosis. J Am Acad Orthop Surg Dec;19(12): Downs SH, Black N. The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions. J Epidemiol Community Health [Internet] Jun [cited 2013 Jan 10];52(6): Available from: 7. Akbarnia BA, Cheung K, Noordeen H, Elsebaie H, Yazici M, Dannawi Z, et al. Next generation of growth-sparing technique: preliminary clinical results of a magnetically controlled growing rod (MCGR) in 14 patients with early onset scoliosis. Spine (Phila Pa 1976 ) Oct Cheung KM, Cheung JP, Samartzis D, Mak KC, Wong YW, Cheung WY, et al. Magnetically controlled growing rods for severe spinal curvature in young children: a prospective case series. Lancet May 26;379(9830): Shilla and MAGEC Systems for Growing Children with Scoliosis 6
7 Appendix 1: Selection of Publications 514 citations identified from electronic literature search and screened (abstracts) Four potentially relevant reports retrieved from other sources (grey literature, hand search) 507 citations excluded 11 potentially relevant articles retrieved for scrutiny (full text) 9 reports excluded 2 reports included in review Shilla and MAGEC Systems for Growing Children with Scoliosis 7
8 Appendix 2: Characteristics of Included Studies Table A1: Characteristics of Included Clinical Trials First Author, Year, Country, Study design; length of follow-up Intervention Comparator(s) Patient characteristics Main clinical outcomes reported Akbarnia, USA Cheung, HongKong Multi-center prospective nonrandomized study. 10-month follow-up (total 68 distractions for 14 patients) Single-center case series (2 cases) 24-month follow-up (total 43 distractions for 2 patients) MAGEC system No comparator MAGEC system No comparator 14 patients with EOS (5 patients with single rod system and 9 patients with dual rod system); mean age 8y + 10m 2 patients with EOS (1 patient with single rod system and 1 patient with dual rod system); age 5 y + 8m and 12y + 1 m m: month; MAGEC: Magnetic Expansion Control System ; EOS: early-onser scoliosis; y: years Cobb angle change Spinal height increase Complications Cobb angle change Spinal height increase Complications Shilla and MAGEC Systems for Growing Children with Scoliosis 8
9 Appendix 3: Summary of Critical Appraisal of Included Studies Table A2: Summary of Critical Appraisal of Included Studies First Author, Strengths Publication Year Akbarnia, hypothesis clearly described method of selection from source population and representation described main outcomes, interventions, patient characteristics, and main findings clearly described estimates of random variability and actual probability values provided losses to follow-up described Limitations patients not randomized unclear whether power calculation was performed to determine adequate sample size Shilla and MAGEC Systems for Growing Children with Scoliosis 9
10 Appendix 4: Main Study Findings and Authors Conclusions Table A3: Main Study Findings and Authors Conclusions First Author, Main Study Findings Publication Year Research question 1 (long-term clinical effectiveness of Shilla and MAGEC) Akbarnia, Cobb angle correction (mean) Cobb angle changed from 60 to 34 after surgery and 31 at latest follow-up (mean 10 months) Single rod system: 46% change Dual rod system: 48 % change Differences in the initial correction and final correction between the 2 techniques (single rod and dual rod) was not statistically significant ( P = 0.91 and P = 0.85) T1 T12 height gain (mean) Single rod: 7.6 mm (1.09 mm/month) Dual rod: mm (1.97 mm/month) Differences were not statistically significant between the 2 systems (P = 0.21) T1 S1 height gain (mean) Single rod: 9.1 mm (1.27 mm/month) Dual rod: 20.3 mm (3.09 mm/month) Differences were statistically significant between the 2 systems (P < 0.05) Authors Conclusions Preliminary results indicated MCGR was safe and provided adequate distraction similar to standard GR. DR achieved better initial curve correction and greater spinal height during distraction compared to SR. No major complications were observed during the FU (p 3) Cheung, Complications (number of patients with events) Superficial wound infection: in 1 single rod patient (1/5) Prominent implant: in 1 dual rod patient (1/9) Partial loss of initial height: in 3 single rod patients (3/5) There was no neurologic deficit or implant failure Cobb angle correction (mean) Cobb angle changed from 67% (SD 10 ) to 29% (SD 4 ) at 24 months Instrumental segment length gain (mean): Single rod (patient1): 1.4 mm per distraction (SD 0.7 mm) Dual rod (patient 2): 1.9 mm per distraction (SD 0.6 mm) for right rod and 1.7 mm per distraction (SD 0.8 mm) for left rod Overall: 1.9 mm per distraction (SD 0.4 mm) Complications (number of patients with events) No pain as measured by VAS Superficial wound infection: in 1 patient (1/2) No prominent implant, There was no neurologic deficit or implant failure Both patients satisfied with medical management; good function and acitivity, self image, and mental health scores as measured by SRS-30 The MCGR procedure can be safely and eff ectively used in outpatient settings, and minimises surgical scarring and psychological distress, improves quality of life, and is more cost-eff ective than is the traditional growing rod procedure ( p 1967) Shilla and MAGEC Systems for Growing Children with Scoliosis 10
11 Table A3: Main Study Findings and Authors Conclusions First Author, Main Study Findings Publication Year Research question 2 (cost-effectiveness of Shilla and MAGEC) Cheung, MAGEC instrumentation costs: HK$50,000; US$6,451 Traditional growing rod: HK$25,000; US$3,225 Authors Conclusions The MCGR procedure can be safely and eff ectively used in outpatient settings, and minimises surgical scarring and psychological distress, improves quality of life, and is more cost-eff ective than is the traditional growing rod procedure ( p 1967) SD: standard deviation; SRS-30 : Scoliosis Research Society questionnaire, version 30; VAS: visual analogue scale Shilla and MAGEC Systems for Growing Children with Scoliosis 11
DATE: 17 July 2012 CONTEXT AND POLICY ISSUES
TITLE: Sterile Pre-filled Saline Syringes for Acute Care Patients: A Review of Clinical Evidence, Cost-effectiveness, Evidence-based Guidelines, and Safety DATE: 17 July 2012 CONTEXT AND POLICY ISSUES
More informationTITLE: Patient-Controlled Analgesia for Acute Injury Transfers: A Review of the Clinical Effectiveness, Safety, and Guidelines
TITLE: Patient-Controlled Analgesia for Acute Injury Transfers: A Review of the Clinical Effectiveness, Safety, and Guidelines DATE: 11 August 2014 CONTEXT AND POLICY ISSUES Patient-controlled analgesia
More informationDATE: 04 April 2012 CONTEXT AND POLICY ISSUES
TITLE: Procedure Site Bleeding Complications Following Percutaneous Coronary Interventions or Angioplasty: A Review of Clinical Evidence and Guidelines DATE: 04 April 2012 CONTEXT AND POLICY ISSUES Percutaneous
More informationTITLE: Montelukast for Sleep Apnea: A Review of the Clinical Effectiveness, Cost Effectiveness, and Guidelines
TITLE: Montelukast for Sleep Apnea: A Review of the Clinical Effectiveness, Cost Effectiveness, and Guidelines DATE: 17 January 2014 CONTEXT AND POLICY ISSUES Obstructive sleep apnea (OSA) is a common
More informationTITLE: Hyperbaric Oxygen Therapy for Adults with Mental Illness: A Review of the Clinical Effectiveness
TITLE: Hyperbaric Oxygen Therapy for Adults with Mental Illness: A Review of the Clinical Effectiveness DATE: 27 August 2014 CONTEXT AND POLICY ISSUES Mental illness, including major depressive episode,
More informationTITLE: Immediate Osseointegrated Implants for Cancer Patients: A Review of Clinical and Cost-Effectiveness
TITLE: Immediate Osseointegrated Implants for Cancer Patients: A Review of Clinical and Cost-Effectiveness DATE: 13 January 2015 CONTEXT AND POLICY ISSUES According to the World health Organization, the
More informationTITLE: Delivery of Electroconvulsive Therapy in Non-Hospital Settings: A Review of the Safety and Guidelines
TITLE: Delivery of Electroconvulsive Therapy in Non-Hospital Settings: A Review of the Safety and Guidelines DATE: 08 May 2014 CONTEXT AND POLICY ISSUES Electroconvulsive therapy (ECT) is a treatment that
More informationThis report will provide a review on the comparative clinical effectiveness and safety between intranasal triamcinolone and beclomethasone.
TITLE: Intranasal Triamcinolone versus Intranasal Beclomethasone for Acute and Chronic Sinus Inflammation: A Review of Comparative Clinical Effectiveness and Safety DATE: 29 January 2013 CONTEXT AND POLICY
More informationClinical Policy: Growing Rods Spinal Surgery Reference Number: CP.MP.354
Clinical Policy: Growing Rods Spinal Surgery Reference Number: CP.MP.354 Effective Date: 06/07 Last Review Date: 10/16 Coding Implications Revision Log See Important Reminder at the end of this policy
More informationTITLE: Discontinuation of Benzodiazepines and Other Sedative-Hypnotic Sleep Medication in Hospitalized Patients: Clinical Evidence and Guidelines
TITLE: Discontinuation of Benzodiazepines and Other Sedative-Hypnotic Sleep Medication in Hospitalized Patients: Clinical Evidence and Guidelines DATE: 25 September 2015 RESEARCH QUESTIONS 1. What is the
More informationClinical Policy: Growing Rods Spinal Surgery Reference Number: HNCA.CP.MP.354
Clinical Policy: Growing Rods Spinal Surgery Reference Number: HNCA.CP.MP.354 Effective Date: 06/07 Last Review Date: 10/18 Coding Implications Revision Log See Important Reminder at the end of this policy
More informationEarly onset scoliosis: The use of growth rods
SA Orthopaedic Journal Autumn 2017 Vol 16 No 1 Page 49 Early onset scoliosis: The use of growth rods RD Govender MBBCh(Wits), FC Orth(SA) AOSpine Fellow at the Spine Surgery Unit, Groote Schuur Hospital
More informationTITLE: Periodic Dental Examinations for Oral Health: A Review of Clinical Effectiveness, Cost Effectiveness, and Guidelines
TITLE: Periodic Dental Examinations for Oral Health: A Review of Clinical Effectiveness, Cost Effectiveness, and Guidelines DATE: 21 May 2014 CONTEXT AND POLICY ISSUES While there is no accepted universal
More informationService Line: Rapid Response Service Version: 1.0 Publication Date: October 30, 2018 Report Length: 7 Pages
CADTH RAPID RESPONSE REPORT: SUMMARY WITH CRITICAL APPRAISAL Topical Silver Nitrate for the Management of Hemostasis: A Review of Clinical Effectiveness, Cost- Effectiveness, and Guidelines Service Line:
More informationTITLE: Use of Bupropion in Patients with Depression and the Associated Risk of Seizures: Safety
TITLE: Use of Bupropion in Patients with Depression and the Associated Risk of Seizures: Safety DATE: 1 April 2010 CONTEXT AND POLICY ISSUES: The prevalence of epilepsy ranges from 0.5% to 1%, 1,2 and
More informationTITLE: Acetylsalicylic Acid for Venous Thromboembolism Prophylaxis: A Review of Clinical Evidence, Benefits and Harms
TITLE: Acetylsalicylic Acid for Venous Thromboembolism Prophylaxis: A Review of Clinical Evidence, Benefits and Harms DATE: 23 August 2011 CONTEXT AND POLICY ISSUES: Thromboembolism occurs when a blood
More informationTITLE: Optimal Oxygen Saturation Range for Adults Suffering from Traumatic Brain Injury: A Review of Patient Benefit, Harms, and Guidelines
TITLE: Optimal Oxygen Saturation Range for Adults Suffering from Traumatic Brain Injury: A Review of Patient Benefit, Harms, and Guidelines DATE: 11 April 2014 CONTEXT AND POLICY ISSUES Traumatic brain
More informationEarly-Onset Spinal Deformity: Decision-Making
Early-Onset Spinal Deformity: Decision-Making Scott J. Luhmann, M.D. Professor Department of Orthopaedic Surgery Washington University School of Medicine Chief of Staff, Shriner s Hospital for Children
More informationTITLE: Probenecid Dosing When Given with Cefazolin: Guidelines and Clinical Effectiveness
TITLE: Probenecid Dosing When Given with Cefazolin: Guidelines and Clinical Effectiveness DATE: 21 November 2008 RESEARCH QUESTIONS: 1. What is the evidence for the clinical effectiveness of the 1g dose
More informationCADTH RAPID RESPONSE REPORT: REFERENCE LIST Side Effect Free Chemotherapy for the Treatment of Cancer: Clinical Effectiveness
CADTH RAPID RESPONSE REPORT: REFERENCE LIST Side Effect Free Chemotherapy for the Treatment of Cancer: Clinical Effectiveness Service Line: Rapid Response Service Version: 1.0 Publication Date: August
More informationTITLE: Crushed Buprenorphine or Buprenorphine-Naloxone for Opioid Dependency: A Review of the Clinical Effectiveness and Guidelines
TITLE: Crushed Buprenorphine or Buprenorphine-Naloxone for Opioid Dependency: A Review of the Clinical Effectiveness and Guidelines DATE: 18 July 2016 CONTEXT AND POLICY ISSUES Opioid dependence is a chronic
More informationCADTH RAPID RESPONSE REPORT: SUMMARY WITH CRITICAL APPRAISAL
CADTH RAPID RESPONSE REPORT: SUMMARY WITH CRITICAL APPRAISAL Day Surgery versus Overnight Stay for Laparoscopic Cholecystectomy and Laparoscopic Hernia Repair: A Review of Comparative Clinical Effectiveness
More informationCheung, JPY; Bow, HYC; Samartzis, D; Kwan, KYH; Cheung, KMC. Citation Journal of Orthopaedic Surgery, 2016, v. 24 n. 3, p
Title Author(s) Frequent small distractions with a magnetically controlled growing rod for early-onset scoliosis and avoidance of the law of diminishing returns Cheung, JPY; Bow, HYC; Samartzis, D; Kwan,
More informationDATE: 21 November 2012 CONTEXT AND POLICY ISSUES
TITLE: Vitamin E Infused Polyethylene Liners, Conventional Polyethylene Liners, and Cross-Linked Polyethylene Liners for Knee Articular Resurfacing in Adults: A Review of Clinical and Cost-Effectiveness
More informationDATE: 10 February 2016 CONTEXT AND POLICY ISSUES
TITLE: Neuromuscular Monitoring for Patients Receiving Continuous Paralytic or Neuromuscular Blocking Agents: A Review of the Clinical Effectiveness and Guidelines DATE: 10 February 2016 CONTEXT AND POLICY
More informationTITLE: Left Atrial Appendage Occlusion: Economic Impact and Existing HTA Recommendations
TITLE: Left Atrial Appendage Occlusion: Economic Impact and Existing HTA Recommendations DATE: 29 September 2010 CONTEXT AND POLICY ISSUES: Atrial fibrillation (AF) is the irregular, rapid beating of the
More informationTITLE: Hyperbaric Oxygen Therapy for Autism: A Review of the Clinical and Cost- Effectiveness
TITLE: Hyperbaric Oxygen Therapy for Autism: A Review of the Clinical and Cost- Effectiveness DATE: 19 November 2009 CONTEXT AND POLICY ISSUES: Autism is a pervasive developmental disorder characterized
More informationTitle: Scoop Stretcher for Restriction of Spinal Motion: Clinical Effectiveness
Title: Scoop Stretcher for Restriction of Spinal Motion: Clinical Effectiveness Date: 28 May 2008 Research question: What is the evidence for the clinical effectiveness of a scoop stretcher to restrict
More informationTITLE: Vacuum Boards for Spinal Motion Restriction: Clinical Effectiveness
TITLE: Vacuum Boards for Spinal Motion Restriction: Clinical Effectiveness DATE: 14 October 2008 RESEARCH QUESTION: What are the clinical benefits and harms of using vacuum boards for spinal motion restriction?
More informationDATE: 09 December 2009 CONTEXT AND POLICY ISSUES:
TITLE: Tiotropium Compared with Ipratropium for Patients with Moderate to Severe Chronic Obstructive Pulmonary Disease: A Review of the Clinical Effectiveness DATE: 09 December 2009 CONTEXT AND POLICY
More informationService Line: Rapid Response Service Version: 1.0 Publication Date: January 21, 2019 Report Length: 5 Pages
CADTH RAPID RESPONSE REPORT: REFERENCE LIST Topical Cantharidin/ Salicylic Acid/ Podophyllin for the Treatment of Warts: Clinical Effectiveness and Guidelines Service Line: Rapid Response Service Version:
More informationTITLE: Naltrexone for the Treatment of Alcohol Dependence in Individuals with Co- Dependencies: A Review of the Clinical Effectiveness
TITLE: Naltrexone for the Treatment of Alcohol Dependence in Individuals with Co- Dependencies: A Review of the Clinical Effectiveness DATE: 08 October 2009 CONTEXT AND POLICY ISSUES: Poly-drug abuse is
More informationTITLE: Critical Incident Stress Debriefing for First Responders: A Review of the Clinical Benefit and Harm
TITLE: Critical Incident Stress Debriefing for First Responders: A Review of the Clinical Benefit and Harm DATE: 12 February 2010 CONTEXT AND POLICY ISSUES: Critical incident stress debriefing (CISD) is
More informationTITLE: Dose of Electrical Current for Biphasic Defibrillators for Synchronous Cardioversion in Patients with Tachyarrhythmia: Guidelines
TITLE: Dose of Electrical Current for Biphasic Defibrillators for Synchronous Cardioversion in Patients with Tachyarrhythmia: Guidelines DATE: 5 May 2009 RESEARCH QUESTION: What recommendations exist for
More informationTITLE: Abuse and Misuse Potential of Dimenhydrinate: A Review of the Clinical Evidence
TITLE: Abuse and Misuse Potential of Dimenhydrinate: A Review of the Clinical Evidence DATE: 01 December 2015 CONTEXT AND POLICY ISSUES Dimenhydrinate (marketed as Gravol in Canada and Dramamine in the
More informationTITLE: Closed Catheter Systems for Prevention of Urinary Tract Infections: A Review of the Clinical Effectiveness
TITLE: Closed Catheter Systems for Prevention of Urinary Tract Infections: A Review of the Clinical Effectiveness DATE: 24 November 2008 CONTEXT AND POLICY ISSUES: Urinary tract infections (UTI) are the
More informationMedical technologies guidance Published: 18 June 2014 nice.org.uk/guidance/mtg18
The MAGEC system for spinal lengthening in children with scoliosis Medical technologies guidance Published: 18 June 2014 nice.org.uk/guidance/mtg18 NICE 2018. All rights reserved. Subject to Notice of
More informationTITLE: Australian Sheepskins for the Management of Pressure Ulcers: A Review of the Clinical-Effectiveness, Cost-Effectiveness, and Guidelines
TITLE: Australian Sheepskins for the Management of Pressure Ulcers: A Review of the Clinical-Effectiveness, Cost-Effectiveness, and Guidelines DATE: 21 July 2009 CONTEXT AND POLICY ISSUES: Pressure ulcers,
More informationCardiopulmonary Resuscitation Feedback Devices for Adult Patients in Cardiac Arrest: A Review of Clinical Effectiveness and Guidelines
TITLE: Cardiopulmonary Resuscitation Feedback Devices for Adult Patients in Cardiac Arrest: A Review of Clinical Effectiveness and Guidelines DATE: 20 April 2015 CONTEXT AND POLICY ISSUES The incidence
More informationDATE: 26 August 2013 CONTEXT AND POLICY ISSUES
TITLE: Nd:YAG Laser for the Treatment of Patients with Hidradenitis Suppurativa: A Review of the Clinical Effectiveness, Cost-Effectiveness, and Safety DATE: 26 August 2013 CONTEXT AND POLICY ISSUES Hidradenitis
More informationTITLE: Fusidic Acid for Ophthalmic Infections: A Review of Clinical and Cost Effectiveness and Safety
TITLE: Fusidic Acid for Ophthalmic Infections: A Review of Clinical and Cost Effectiveness and Safety DATE: 22 February 2013 CONTEXT AND POLICY ISSUES The antibiotic fusidic acid is available in a 1% suspension
More informationTitle: Shortened Dental Arch and Restorative Therapies: Evidence for Functional Dentition
Title: Shortened Dental Arch and Restorative Therapies: Evidence for Functional Dentition Date: 15 May 2008 Context and policy issues: For patients who lose teeth due to various reasons, a fundamental
More informationTITLE: Gabapentin for HIV-associated Neuropathic Pain: A Review of the Clinical Effectiveness
TITLE: Gabapentin for HIV-associated Neuropathic Pain: A Review of the Clinical Effectiveness DATE: 22 January 2016 CONTEXT AND POLICY ISSUES Neuropathic pain can be severe and debilitating and results
More informationDATE: 22 June 2015 CONTEXT AND POLICY ISSUES
TITLE: Non-Invasive Methods for Diagnosis and Monitoring of Liver Fibrosis in Patients with Chronic Hepatitis B and C: A Review of Diagnostic Accuracy, Clinical Effectiveness, Cost-Effectiveness and Guidelines
More informationService Line: Rapid Response Service Version: 1.0 Publication Date: March 5, 2018 Report Length: 5 Pages
CADTH RAPID RESPONSE REPORT: REFERENCE LIST Oral Neomycin in Preparation for Colorectal Procedures: Clinical Effectiveness, Cost- Effectiveness and Guidelines Service Line: Rapid Response Service Version:
More informationTitle: Parenteral Iron Therapy for Anemia: A Clinical and Cost-Effectiveness Review
Title: Parenteral Iron Therapy for Anemia: A Clinical and Cost-Effectiveness Review Date: 14 February 2008 Context and policy issues: Anemia is a complication of chronic diseases and commonly occurs in
More informationEarly onset scoliosis and its treatments
Find this article online at www.sauk.org.uk/scoliosis-information/eos-and-treatments Early onset scoliosis and its treatments Early onset scoliosis (EOS) is the occurrence of scoliosis before the age of
More informationPediatric scoliosis. Patient and family guide to understanding
Patient and family guide to understanding Pediatric scoliosis This brochure is not meant to replace any personal conversations that the patient and family might wish to have with the physician or healthcare
More informationDATE: 22 May 2013 CONTEXT AND POLICY ISSUES
TITLE: Intraperitoneal versus Intravenous Chemotherapy for the Treatment of Ovarian Cancer: A Review of the Comparative Clinical Evidence, Safety, Cost- Effectiveness, and Guidelines DATE: 22 May 2013
More informationTITLE: Mattresses for Chronic Back or Neck Pain: A Review of the Clinical Effectiveness and Guidelines
TITLE: Mattresses for Chronic Back or Neck Pain: A Review of the Clinical Effectiveness and Guidelines DATE: 14 May 2014 CONTEXT AND POLICY ISSUES Persistent back pain is a common presentation in primary
More informationTitle: Re-using the Canister Portion of Metered Dose Inhalers in a Hospital Setting: Clinical Review of Safety, Cost-Effectiveness and Guidelines
Title: Re-using the Canister Portion of Metered Dose Inhalers in a Hospital Setting: Clinical Review of Safety, Cost-Effectiveness and Guidelines Date: 16 June 2008 Context and policy issues: A metered
More informationVertical Expandable Prosthetic Titanium Rib. Description
Subject: Vertical Expandable Prosthetic Titanium Rib Page: 1 of 8 Last Review Status/Date: September 2015 Vertical Expandable Prosthetic Titanium Rib Description The vertical expandable prosthetic titanium
More informationTitle: Elective Endovascular Abdominal Aortic Aneurism Repair versus Open Surgery: A Clinical and Cost Effectiveness Review
Title: Elective Endovascular Abdominal Aortic Aneurism Repair versus Open Surgery: A Clinical and Cost Effectiveness Review Date: 07 April 2008 Context and policy issues: Abdominal aortic aneurism (AAA)
More informationTITLE: Type of Thermometer for Inpatients: Clinical-Effectiveness and Guidelines
TITLE: Type of Thermometer for Inpatients: Clinical-Effectiveness and Guidelines DATE: 28 May 2009 RESEARCH QUESTIONS: 1. What is the clinical-effectiveness of tympanic, temporal, oral, and rectal thermometers
More informationDate: 23 June Context and policy issues:
Title: Basiliximab for Immunosuppression During a Calcineurin Inhibitor Holiday in Renal Transplant Patients with Acute Renal Dysfunction: Guidelines for Use and a Clinical and Cost-Effectiveness Review
More informationCADTH RAPID RESPONSE REPORT: SUMMARY WITH CRITICAL APPRAISAL
CADTH RAPID RESPONSE REPORT: SUMMARY WITH CRITICAL APPRAISAL Central Venous Access Devices (CVADs) and Peripherally Inserted Central Catheters (PICCs) for Adult and Pediatric : A Review of Clinical Effectiveness
More informationTITLE: Long-acting Opioids for Chronic Non-cancer Pain: A Review of the Clinical Efficacy and Safety
TITLE: Long-acting Opioids for Chronic Non-cancer Pain: A Review of the Clinical Efficacy and Safety DATE: 27 August 2015 CONTEXT AND POLICY ISSUES Chronic non-cancer pain (CNCP) of neuropathic or proprioceptive
More informationTITLE: Metal on Metal Total Hip Replacements or Hip Resurfacing for Adults: A Review of Clinical Effectiveness and Cost Effectiveness
TITLE: Metal on Metal Total Hip Replacements or Hip Resurfacing for Adults: A Review of Clinical Effectiveness and Cost Effectiveness DATE: 15 November 2012 CONTEXT AND POLICY ISSUES Total hip replacement
More informationService Line: Rapid Response Service Version: 1.0 Publication Date: June 12, 2018 Report Length: 5 Pages
CADTH RAPID RESPONSE REPORT: SUMMARY OF ABSTRACTS Sensory Rooms for Pediatric Patients with Neurocognitive Disorders: Clinical Effectiveness and Guidelines Service Line: Rapid Response Service Version:
More informationVertical Expandable Prosthetic Titanium Rib (VEPTR)
Vertical Expandable Prosthetic Titanium Rib (VEPTR) Policy Number: 7.01.110 Last Review: 10/2017 Origination: 9/2007 Next Review: 10/2018 Policy Blue Cross and Blue Shield of Kansas City (Blue KC) will
More informationService Line: Rapid Response Service Version: 1.0 Publication Date: August 30, 2018 Report Length: 11 Pages
CADTH RAPID RESPONSE REPORT: SUMMARY WITH CRITICAL APPRAISAL Radioembolization with yttrium-90 Microspheres for the Management of Uveal Melanoma Liver Metastases: A Review of Clinical Effectiveness and
More informationVertical Expandable Prosthetic Titanium Rib (VEPTR)
Vertical Expandable Prosthetic Titanium Rib (VEPTR) Policy Number: 7.01.110 Last Review: 10/2018 Origination: 9/2007 Next Review: 10/2019 Policy Blue Cross and Blue Shield of Kansas City (Blue KC) will
More informationFocus. N. Kabirian, B.A. Akbarnia * ORIGINAL ARTICLE Update on spine based surgical treatment of early onset scoliosis: what do we know in 2012?
50 Evolution in diagnosis and treatment of scoliosis ORIGINAL ARTICLE Update on spine based surgical treatment of early onset scoliosis: what do we know in 2012? N. Kabirian, B.A. Akbarnia * San Diego
More informationEarly Onset Scoliosis
Early Onset Scoliosis GSF-0616-326 Created in collaboration with: Growing Spine Foundation 555 East Wells Street, Suite 1100 Milwaukee, WI 53202 USA P: (414) 276-6445 F: (414) 276-3349 info@growingspine.org
More informationDATE: 29 Aug 2012 CONTEXT AND POLICY ISSUES
TITLE: Tiotropium Compared with Ipratropium for Patients with Moderate to Severe Chronic Obstructive Pulmonary Disease: A Review of the Clinical Effectiveness DATE: 29 Aug 2012 CONTEXT AND POLICY ISSUES
More informationDATE: 28 May 2015 CONTEXT AND POLICY ISSUES
TITLE: Neonatal Vitamin K Administration for the Prevention of Hemorrhagic Disease: A Review of the Clinical Effectiveness, Comparative Effectiveness, and Guidelines DATE: 28 May 2015 CONTEXT AND POLICY
More informationTITLE: Chiropractic Interventions for Acute or Chronic Lower Back Pain in Adults: A Review of the Clinical and Cost-Effectiveness
TITLE: Chiropractic Interventions for Acute or Chronic Lower Back Pain in Adults: A Review of the Clinical and Cost-Effectiveness DATE: 10 February 2009 CONTEXT AND POLICY ISSUES: Low back pain (LBP) is
More informationEarly surgical treatment may be necessary for children. Magnetically Controlled Devices Parallel to the Spine in Children with Spinal Muscular Atrophy
Magnetically Controlled Devices Parallel to the Spine in Children with Spinal Muscular Atrophy Heiko M. Lorenz, MD, Batoul Badwan, Marina M. Hecker, Konstantinos Tsaknakis, MD, Katharina Groenefeld, DDS,
More informationTITLE: Olopatadine for the Treatment of Allergic Conjunctivitis: A Review of the Clinical Efficacy, Safety, and Cost-Effectiveness
TITLE: Olopatadine for the Treatment of Allergic Conjunctivitis: A Review of the Clinical Efficacy, Safety, and Cost-Effectiveness DATE: 17 March 2016 CONTEXT AND POLICY ISSUES Allergic conjunctivitis,
More informationIncreasing Frequency of Self-Monitoring Blood Glucose Test Strips During Pregnancy: A Review of the Clinical and Cost- Effectiveness and Guidelines
CADTH RAPID RESPONSE REPORT: SUMMARY WITH CRITICAL APPRAISAL Increasing Frequency of Self-Monitoring Blood Glucose Test Strips During Pregnancy: A Review of the Clinical and Cost- Effectiveness and Guidelines
More informationSerial Derotational Casting in Congenital Scoliosis as a Time-buying Strategy
ORIGINAL ARTICLE Serial Derotational ing in Congenital Scoliosis as a Time-buying Strategy Halil G. Demirkiran, MD,* Senol Bekmez, MD,w Rustem Celilov, MD,* Mehmet Ayvaz, MD,* Ozgur Dede, MD,z and Muharrem
More information10/9/2017 POST OP CARE OF THE PEDIATRIC SPINE PATIENT OBJECTIVES DEFINITION OF SCOLIOSIS CAUSES TYPES
POST OP CARE OF THE PEDIATRIC SPINE PATIENT BY: JUDITH MILETTO, RN-BSN NICOLE RALSTON, RN WE HAVE NO DISCLOSURES OR CONFLICT OF INTEREST OBJECTIVES DEFINITION OF SCOLIOSIS The participant will be able
More informationTITLE: Long-term Use of Acamprosate Calcium for Alcoholism: A Review of the Clinical Effectiveness, Safety, and Guidelines
TITLE: Long-term Use of Acamprosate Calcium for Alcoholism: A Review of the Clinical Effectiveness, Safety, and Guidelines DATE: 29 May 2015 CONTEXT AND POLICY ISSUES Alcoholism or alcohol dependence is
More informationClinical Review Report (Sample)
CADTH COMMON DRUG REVIEW Clinical Review Report (Sample) GENERIC DRUG NAME (BRAND NAME) (Manufacturer) Indication: Text Disclaimer: The information in this document is intended to help Canadian health
More informationVEPTR TM Growing Rods for Early-onset Neuromuscular Scoliosis
Clin Orthop Relat Res (2011) 469:1335 1341 DOI 10.1007/s11999-010-1749-y SYMPOSIUM: EARLY ONSET SCOLIOSIS VEPTR TM Growing Rods for Early-onset Neuromuscular Scoliosis Feasible and Effective Klane K. White
More informationHealth Interventions in Ambulatory Cancer Care Centres DRAFT. Objectives. Methods
ENVIRONMENTAL SCAN Health Interventions in Ambulatory Cancer Care Centres Context Cancer, a complex, chronic condition, will affect an estimated two in five Canadians in their lifetime. 1 Cancer requires
More informationTITLE: Cryotherapy Systems for Wart Removal: A Review of the Clinical Effectiveness, Cost-effectiveness, and Guidelines
TITLE: Cryotherapy Systems for Wart Removal: A Review of the Clinical Effectiveness, Cost-effectiveness, and Guidelines DATE: 12 June 2014 CONTEXT AND POLICY ISSUES Cutaneous viral warts, a common skin
More informationCADTH RAPID RESPONSE REPORT: SUMMARY WITH CRITICAL APPRAISAL
CADTH RAPID RESPONSE REPORT: SUMMARY WITH CRITICAL APPRAISAL Endodontic Therapy Interventions for Root Canal Failure in Permanent Dentition: A Review of Clinical Effectiveness, Cost- Effectiveness, and
More informationCasting. Early Onset Scoliosis: The Value of Serial Risser Casts. Serial Risser Casts 1/4/2014
VuMedi Webinar Current Concepts in EOS 6 January 2014 Casting George H.Thompson, MD Director, Pediatric Orthopaedics Rainbow Babies and Children s Hospital Case Western Reserve University Cleveland, Ohio,
More informationVertical Expandable Prosthetic Titanium Rib. Description
Subject: Vertical Expandable Prosthetic Titanium Rib Page: 1 of 7 Last Review Status/Date: September 2014 Vertical Expandable Prosthetic Titanium Rib Description The vertical expandable prosthetic titanium
More informationFusionless Surgery for Scoliosis
49 Fusionless Surgery for Scoliosis Stuart H. Hershman, M.D., Justin J. Park, M.D., and Baron S. Lonner, M.D. Abstract Scoliosis is a very common condition, affecting approximately 7 million children in
More informationGoals of management in early-onset scoliosis (EOS)
Rib-Based Anchors for Growing Rods in the Treatment of Early-Onset Scoliosis Daniel J. Miller, MD, and Michael G. Vitale, MD, MPH The treatment of early-onset scoliosis (EOS) has evolved substantially
More informationTitle: Ultrasound for Breast Cancer Screening: Clinical Effectiveness. Date: 4 January Context and policy issues:
Title: Ultrasound for Breast Cancer Screening: Clinical Effectiveness Date: 4 January 2008 Context and policy issues: It is estimated that 22,300 women will be diagnosed with breast cancer and approximately
More informationDate: March 2007 Review date: recommended for review in 2009
1 Title Idiopathic Scoliosis Interventions with exercise and manual therapy Prepared by: Anne Braund (annebraund@rogers.com or annergy.centre@bellnet.ca) Date: March 2007 Review date: recommended for review
More informationTITLE: Nutritional Supplementation for Patients with Cancer: A Review of the Clinical Effectiveness and Guidelines
TITLE: Nutritional Supplementation for Patients with Cancer: A Review of the Clinical Effectiveness and Guidelines DATE: 12 February 2014 CONTEXT AND POLICY ISSUES People with cancer who are well nourished
More informationDATE: 12 January 2017 CONTEXT AND POLICY ISSUES
TITLE: Basal-Bolus Versus Sliding-Scale Insulin Therapy in the Acute Care Hospital Setting: A Review of Comparative Clinical Effectiveness and Cost-Effectiveness DATE: 12 January 2017 CONTEXT AND POLICY
More informationName of Policy: Vertical Expandable Prosthetic Titanium Rib
Name of Policy: Vertical Expandable Prosthetic Titanium Rib Policy #: 299 Latest Review Date: June 2013 Category: Surgery Policy Grade: C Background/Definitions: As a general rule, benefits are payable
More informationComparison of single and dual growing rods in the treatment of early onset scoliosis: a meta-analysis
Xu et al. Journal of Orthopaedic Surgery and Research (2016) 11:80 DOI 10.1186/s13018-016-0413-y RESEARCH ARTICLE Open Access Comparison of single and dual growing rods in the treatment of early onset
More informationTITLE: Computed Tomography: A Review of the Risk of Cancer Associated with Radiation Exposure
TITLE: Computed Tomography: A Review of the Risk of Cancer Associated with Radiation Exposure DATE: 18 August 2009 CONTEXT AND POLICY ISSUES: Health care professionals order diagnostic imaging for their
More informationService Line: Rapid Response Service Version: 1.0 Publication Date: April 4, 2018 Report Length: 14 Pages
CADTH RAPID RESPONSE REPORT: SUMMARY WITH CRITICAL APPRAISAL Chest X-Rays Around Placement in Long-Term Care Facilities: A Review of Clinical Utility and Guidelines Service Line: Rapid Response Service
More informationTITLE: Optimal Care of Chronic, Non-Healing, Lower Extremity Wounds: A Review of Clinical Evidence and Guidelines
TITLE: Optimal Care of Chronic, Non-Healing, Lower Extremity Wounds: A Review of Clinical Evidence and Guidelines DATE: 17 December 2013 CONTEXT AND POLICY ISSUES Chronic wounds are those which do not
More informationTITLE: Memantine in Combination with Cholinesterase Inhibitors for Alzheimer s Disease: Clinical Effectiveness
TITLE: Memantine in Combination with Cholinesterase Inhibitors for Alzheimer s Disease: Clinical Effectiveness DATE: 30 October 2008 RESEARCH QUESTION: What is the evidence for using memantine in combination
More informationDATE: 21 March 2013 CONTEXT AND POLICY ISSUES
TITLE: Tricyclic Antidepressants, Clonidine, Venlafaxine, and Modafinil for the Treatment of Attention-Deficit/Hyperactivity Disorder in Adults: A Review of the Clinical Evidence DATE: 21 March 2013 CONTEXT
More informationCurrent status of managing pediatric kyphosis deformity Papers divided into 3 categories
Biomechanical and Clinical Evaluation of Rib Anchors Richard H. Gross, MD Research Professor, Clemson University Clemson-MUSC Bioengineering Consortium Charleston, SC Staff surgeon, Shriners Hospital,
More informationTITLE: Dicyclomine for Gastrointestinal Conditions: A Review of the Clinical Effectiveness, Safety, and Guidelines
TITLE: Dicyclomine for Gastrointestinal Conditions: A Review of the Clinical Effectiveness, Safety, and Guidelines DATE: 03 December 2015 CONTEXT AND POLICY ISSUES Dicyclomine, also known as dicycloverine,
More informationCADTH Therapeutic Review
Canadian Agency for Drugs and Technologies in Health Agence canadienne des médicaments et des technologies de la santé CADTH Therapeutic Review August 2012 Volume 1, Issue 1A Antithrombotic Therapy for
More informationScoliosis David S. Feldman, MD
Scoliosis David S. Feldman, MD Chief of Pediatric Orthopedic Surgery Professor of Orthopedic Surgery & Pediatrics NYU Langone Medical Center & NYU Hospital for Joint Diseases Overview Idiopathic scoliosis
More informationSurgical Technique Guide MAGEC Remote Control Technology for the Treatment of Spine Deformities
Surgical Technique Guide MAGEC Remote Control Technology for the Treatment of Spine Deformities i MAGEC TECHNIQUE GUIDE ii MAGEC TECHNIQUE GUIDE Goal of treatment The MAGEC System is designed to brace
More informationTITLE: Tranexamic Acid for the Management of Bleeding: A Review of the Clinical Effectiveness and Guidelines
TITLE: Tranexamic Acid for the Management of Bleeding: A Review of the Clinical Effectiveness and Guidelines DATE: 24 June 2013 CONTEXT AND POLICY ISSUES Bleeding or hemorrhage indicates a blood loss from
More informationCADTH RAPID RESPONSE REPORT: SUMMARY WITH CRITICAL APPRAISAL
CADTH RAPID RESPONSE REPORT: SUMMARY WITH CRITICAL APPRAISAL Lifetime History-Informed Treatment for Chronic Pain, Mobility Impairment, or Organ Systems Dysfunction: A Review of Clinical Effectiveness
More information